| NPI | 1376279679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BUCKINGHAM VP Of It And Compliance 307-751-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2022-07-28 |